Papers

International journal
Jan, 2018

Impact of premature activation of the right ventricle with programmed stimulation in Brugada syndrome.

Journal of cardiovascular electrophysiology
  • Koji Nakagawa
  • Satoshi Nagase
  • Hiroshi Morita
  • Tadashi Wada
  • Masamichi Tanaka
  • Masato Murakami
  • Atsuyuki Watanabe
  • Nobuhiro Nishii
  • Kazufumi Nakamura
  • Kengo F Kusano
  • Hiroshi Ito
  • Tohru Ohe
  • Display all

Volume
29
Number
1
First page
71
Last page
78
Language
English
Publishing type
Research paper (scientific journal)
DOI
10.1111/jce.13336

BACKGROUND: In Brugada syndrome (BrS), it has been reported that delayed activation in the RV is related to the development of type-1 ECG, which is more critical than type-2. On the other hand, the coexistence of complete right bundle-branch block (CRBBB), which also causes delayed activation in the RV, sometimes makes typical BrS ECG misleading. We hypothesized that premature stimulation of the RV can unmask the influence of delayed activation in the RV and convert the morphology of ECG in BrS patients. METHODS AND RESULTS: In 35 BrS patients with type-1 ECG including 8 patients with concomitant CRBBB and 6 control subjects with CRBBB, progressively premature single stimulations were delivered from the RV apex on electrophysiological study. Then we evaluated QRS morphology of fusion beats created by single premature stimulation in each patient. In 29 (83%) of 35 of the BrS patients, conversion from type-1 to type-2 ECG was observed during the process of single premature stimulation. Additionally, in all 8 BrS patients with concomitant CRBBB, type-1 or type-2 BrS ECG was revealed by premature stimulation with relief of CRBBB. These findings were not observed in any of the control subjects with CRBBB. CONCLUSION: Single premature stimulation of the RV converts ECG from type-1 to type-2 in most BrS cases and unmasks type-1 ECG in all BrS cases with CRBBB. Our results could suggest that type-1 ECG is associated with delayed activation of the RV compared with type-2 ECG.

Link information
DOI
https://doi.org/10.1111/jce.13336
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/28884873
ID information
  • DOI : 10.1111/jce.13336
  • Pubmed ID : 28884873

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